Early mobilization in the critical care unit: A review of adult and pediatric literature

被引:186
作者
Cameron, Saoirse [1 ,2 ]
Ball, Ian [2 ,3 ]
Cepinskas, Gediminas [2 ,4 ]
Choong, Karen [1 ,5 ]
Doherty, Timothy J. [1 ,2 ,6 ]
Ellis, Christopher G. [2 ,3 ,4 ]
Martin, Claudio M. [2 ,3 ]
Mele, Tina S. [2 ,7 ]
Sharpe, Michael [2 ,8 ]
Shoemaker, J. Kevin [1 ,2 ,9 ]
Fraser, Douglas D. [1 ,2 ,10 ]
机构
[1] Funct Recovery Critically Ill Children Wee Cover, London, England
[2] Targeted Exercise Reduce Morbid & Mortal Severe S, London, England
[3] Univ Western Ontario, Med, London, ON, Canada
[4] Univ Western Ontario, Med Biophys, London, ON, Canada
[5] McMaster Univ, Pediat, Hamilton, ON, Canada
[6] Univ Western Ontario, Phys Med & Rehabil, London, ON, Canada
[7] Univ Western Ontario, Surg, London, ON, Canada
[8] Univ Western Ontario, Anesthesia & Perioperat Med, London, ON, Canada
[9] Univ Western Ontario, Kinesiol, London, ON, Canada
[10] Univ Western Ontario, Pediat, London, ON, Canada
关键词
Intensive care unit; Mobility; Exercise; Intervention; Adult; Pediatric; ICU-ACQUIRED WEAKNESS; CRITICAL ILLNESS POLYNEUROPATHY; ELECTRICAL MUSCLE STIMULATION; RESPIRATORY-DISTRESS-SYNDROME; RANDOMIZED CONTROLLED-TRIAL; ILL PATIENTS; MECHANICAL VENTILATION; PHYSICAL-THERAPY; PHYSIOLOGICAL-RESPONSES; FUNCTIONAL RECOVERY;
D O I
10.1016/j.jcrc.2015.03.032
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. Pediatric ICU data are limited, but recent studies also suggest that early mobilization is achievable without increasing patient risk. In this review, we provide a current and comprehensive appraisal of ICU mobilization techniques in both adult and pediatric critically ill patients. Contra-indications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:664 / 672
页数:9
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